Organization Active NPI

Lindstrom Eye & Laser Center, P.a.

  • Ophthalmology Physician
  • Laurel, MS
National Provider Identifier
1780724583
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LINDSTROM EYE & LASER CENTER, P.A.
Practice address
1020 Adams St
Laurel, MS 39440-4365
Phone
(601) 426-9454
Fax
(601) 426-9476
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Judith Bradley, M.D.
Title
M.D.
Phone
(601) 428-0999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1020 Adams St
Laurel, MS 39440-4365

Mailing address

PO Box 407
Laurel, MS 39441-0407
Phone (601) 426-9454

Other identifiers 1

IdentifierTypeStateIssuer
09013550MedicaidMS

National Provider Directory

National Provider Directory

Locations

1020 Adams St
Laurel, MS 39440
Phone (601) 426-9454

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780724583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410407",
            "telephone_number": "601-426-9454",
            "fax_number": "601-426-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 ADAMS ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404365",
            "telephone_number": "601-426-9454",
            "fax_number": "601-426-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDSTROM EYE & LASER CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "601-428-0999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013550",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.